The link between sleep and erectile dysfunction

ZipHealth Team

• 10 min read
The link between sleep and erectile dysfunction

If you've ever felt too tired for sex, you're not alone. Many people, including those in their relationships, report feeling too tired for sex on a regular basis.[1] Poor sleep can do more than just lower your energy throughout the day. Sleep also has an important relationship with your sexual health and your erections. Many studies suggest a strong connection between sleep patterns and erectile dysfunction (ED), making sleep not just a lifestyle factor, but a crucial part of men’s sexual health.[2][3] 

Thankfully, if you’re struggling with sleep and sexual health, there are plenty of options for intervention. The first port of call is to understand how sleep and sexual health work together, and what may be causing your erectile dysfunction.

Understanding erectile dysfunction (ED)

Erectile dysfunction refers to the ongoing difficulty in achieving or maintaining an erection firm enough for sex. It's more common than you might think — affecting an estimated 1 in 10 men in the US at some point in their lives.[4] While it’s often associated with aging, ED can happen at any age and is influenced by a variety of physical, psychological, and lifestyle factors.

Causes range from cardiovascular issues to anxiety and low testosterone. Sleep, as it turns out, plays a role in almost all of these factors — yet it’s often overlooked in conversations about sexual health and erectile dysfunction.

Why sleep matters for men's sexual health

Sleep is more than rest. It’s a time when your body does critical repair work, restoring hormone balance, and recalibrating your brain. For men, one of the key hormones affected by sleep is testosterone. That's where things start to link closely to sexual performance.

Testosterone levels naturally rise during sleep, especially during the rapid eye movement (REM) phase.[5] This is the deepest stage of your sleep characterized by vivid dreaming, rapid eye movements, and increased brain activity, similar to when you're awake. This stage is important to sexual health as men produce the majority of their daily testosterone while they’re asleep. When sleep is disrupted or shortened, so is testosterone production. And lower testosterone has been linked to a decrease in libido and erectile function.[6]

How sleep affects erections

Erections aren’t just about arousal. They’re a complex process involving blood flow, nerve function, and hormonal signals. All of these systems are influenced by sleep. Here’s a breakdown of how this works:

  • The brain’s command center: A part of the human brain, your hypothalamus regulates both the sleep-wake cycle (known as your circadian rhythm) and sexual function via your pituitary gland, which controls testosterone release.[7] A bad night’s sleep, or ongoing poor sleep health, can interfere with this system affecting both your circadian rhythm and your testosterone production.[8]
  • Autonomic nervous system: This system helps regulate erections and it’s also sensitive to sleep disruption. Inadequate rest can increase sympathetic (stress-related) activity, which can reduce blood flow to the penis.[9]
  • Testosterone dips: One study found that even one week of restricted sleep (fewer than 5 hours per night) can reduce testosterone levels by 10–15%. That's enough to cause noticeable changes in libido and performance.[10]

Sleep disorders that may contribute to ED

If you have pre-existing health issues with sleep, this could be contributing to ED. Some men have chronic issues with sleep that go beyond just staying up too late. Certain sleep disorders are strongly associated with erectile dysfunction, including:

  • Sleep Apnea: Obstructive sleep apnea (OSA) is a condition where breathing repeatedly stops and starts during sleep. It’s been linked to low oxygen levels, reduced testosterone, and inflammation — all of which can impact erectile function. Several studies suggest that up to 70% of men with OSA also experience ED.[11]
  • Insomnia: Trouble falling or staying asleep doesn’t just make you feel tired — it can increase cortisol (stress hormone) and reduce testosterone, leading to reduced sexual desire and performance.[12]
  • Restless Leg Syndrome (RLS): This condition causes unpleasant leg sensations that disturb sleep. Some research suggests men with RLS are more likely to experience ED likely due to poor sleep quality.[13]

Inflammation, hormones, and brain chemistry

It’s not just sleep duration that matters. The quality of sleep is equally important to erectile function and overall sleep health. Disrupted or fragmented sleep has been shown to increase inflammation in the body, which can damage blood vessels including those needed for healthy erections.[14]

There’s also evidence that sleep deprivation affects chemicals like adenosine and neuropeptide Y, which are involved in regulating blood flow and stress response. Both are linked to sexual performance in scientific studies. Simply put, your brain and body aren’t getting the reset they need without enough rest.[15]

ED isn’t always physical and neither is poor sleep. Anxiety, depression, and stress are all known to disrupt sleep, and they’re also common contributors to sexual dysfunction, including erectile dysfunction or unreliable erections.[16]

Unfortunately, the relationship is circular. Sleep problems can cause mental health symptoms, which can worsen both sleep and sexual function. Men with untreated insomnia, for example, are more likely to report ED. And men experiencing ED often develop performance anxiety, which can further disturb sleep.[17]

Rest assured, there are plenty of solutions you can explore to combat this cycle. And experiencing sleep and erectile issues ongoingly make it especially important to address the root causes as well as treating the symptoms.

What you can do: treatments and lifestyle tips

If you're dealing with ED and also noticing sleep issues, it’s worth speaking to a healthcare provider. In many cases, treating sleep disorders (like starting a medication plan or using a CPAP machine for sleep apnea) has been shown to significantly improve erectile function.[18] It’s always important to speak to your healthcare provider about your sleep health if you have concerns about it, especially if it's affecting your sexual health and especially before starting any treatments.

For others, a few lifestyle changes can make a big difference:

  • Set a consistent sleep schedule: Aim for 7–9 hours of sleep per night.
  • Create a wind-down routine: Avoid screens before bed and reduce caffeine late in the day.
  • Exercise regularly: Physical activity improves both sleep and sexual function.
  • Manage stress: Try mindfulness, breathing exercises or cognitive behavioral therapy (CBT).

Sleep is often seen as something we can cut back on to make time for everything else. But when it comes to sexual health, and especially erectile function, consistent, high-quality sleep is essential.

If you’ve noticed changes in your erections, libido, or sexual performance, take a moment to assess your sleep habits. Getting a better night’s rest could be a key piece of the puzzle.

Other interventions for sleep health and erectile functionIf lifestyle adjustments and sleep improvements aren't fully addressing your erectile dysfunction (ED), MedExpress offers a range of clinically approved treatments that can help from oral medications like Viagra (sildenafil) to topical creams and lifestyle-focused interventions.These medications are designed to enhance blood flow to the penis, improving your ability to achieve and maintain an erection when sexually aroused.[19]

Sildenafil (Generic Viagra)Sildenafil is the active ingredient in Viagra and is available in its generic form at ZipHealth. It's a cost-effective option that typically takes effect within 30–60 minutes and lasts for up to six hours. This medication is taken on demand and is suitable for men seeking reliable, short-term support for erections.[20]

Viagra (Sildenafil)As the original branded version of sildenafil, Viagra® offers the same efficacy with the assurance of a well-known name. It also takes 30–60 minutes to work and provides support for up to 6 hours. This option may appeal to those who prefer brand-name medications.[21]

Tadalafil (Generic Cialis)Tadalafil is known for its longer duration of action, lasting up to 36 hours. It can be taken on demand or daily, offering flexibility for men who prefer spontaneity. The daily option provides continuous support, which can be beneficial for those with more frequent sexual activity.[22]

Cialis® (Tadalafil)Cialis® is the branded version of tadalafil and shares the same long-lasting effects. It can be taken either on demand or daily, depending on your lifestyle and preferences. This medication is ideal for men seeking extended support and the convenience of not timing doses around sexual activity.

Spedra® (Avanafil)Spedra® contains avanafil, a fast-acting PDE5 inhibitor that can take effect in as little as 15 minutes. It provides support for up to 6 hours and can be taken with or without food, offering greater flexibility. This option is suitable for men looking for a quicker onset of action.[23]

Vardenafil (Generic Levitra®)Vardenafil is another effective PDE5 inhibitor, particularly noted for its suitability in men with diabetes. It takes about 25–60 minutes to work and lasts for up to five hours. This medication can be taken with or without food, making it a convenient choice. [24]

It's important to remember that these medications may cause side effects such as headaches, facial flushing, or nasal congestion. More serious risks include interactions with nitrate medications and rare cases of prolonged erections (called priapism) or vision changes. It’s important to consult a healthcare provider to determine if these medications are safe for you.

If low testosterone is a concern, your doctor may recommend blood tests and, in some cases, hormone replacement therapy, before taking medications. If you have any concerns at all about starting erectile dysfunction treatment, you should speak to your healthcare provider.If you’re struggling with sleep and it’s having an impact on your erectile health, it’s not the be all or end all. You are not alone and there are plenty of methods from lifestyle changes to treatment options at your disposal.ZipHealth offers discreet, fast access to ED treatments and expert advice — all online. If you're concerned about ED, start a free consultation today.

References

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